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General NPI Number Information
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NPI Number | 1750493284
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Entity Type | Individual
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Provider Name | RONALD E ELLINGTON LPCC
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/10/2017
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Provider Practice Location Address
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Address Line | 500 N MAIN ST STE STE .421
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City | ROSWELL
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State | NM
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Zip | 88201-4729
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Country | US
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Telephone | 575-627-2233
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4427
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City | ROSWELL
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State | NM
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Zip | 88202-4427
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Country | US
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Telephone | 575-622-2426
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1501
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License Number State | NM
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